Stent Embolization Mimicking Acute Myocardial Infarction.

Venous thromboembolism is associated with significant morbidity and mortality if left untreated. Anticoagulation is the cornerstone of treatment. Venous stents are a relatively newer entity that are increasingly being used to treat venous stenosis/occlusion. It is a safe procedure, but complications include vein rupture, arterial puncture, retroperitoneal bleeding, and in-stent thrombosis. Stent migration is a rare but potentially fatal complication. We present a case of venous stent embolization to the heart that presented as a non-ST segment elevation myocardial infarction.

An Unexpected Factor to Wellens Syndrome.

Factor V Leiden deficiency, the most common inherited thrombophilia, is a risk factor for venous thromboembolism in both the heterozygous and homozygous forms. An autosomal dominant genetic condition, the pattern of incomplete penetrance leads to variable manifestations of the disease. The association with arterial thromboembolism remains controversial, with studies indicating modest increases in risk of coronary artery disease, stroke. We present the case of a 53-year-old male with Wellens syndrome, with a history of heterozygous factor V Leiden deficiency and no other risk factors. Coronary angiography found a complete total occlusion of the proximal left anterior descending artery, with established collaterals, ultimately requiring coronary artery bypass graft. Laboratory testing effectively eliminated the presence of any alternative known risk factors for the advanced coronary artery disease. The literature evaluating a possible link between factor V Leiden deficiency and atherosclerosis remain conflicting. Our case highlights a concerning association and need for further studies.